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Describe the primary differences between nursing research and evidence based practice. Describe your anticipated role/utilization in these areas based on your level of education and scope of practice in the next phase of your career. https://youtu.be/-saL_vpSSf4 https://youtu.be/LWLYCYeCFak https://youtu.be/pUn6Ss94eOo odule 1b: What is Quality Improvement (QI)? Picture_define the problem.jpeg What is Quality Improvement? Joanna Briggs Institute: http://joannabriggs.org/ Defining Quality Improvement http://patientsafetyed.duhs.duke.edu/module_a/module_overview.html http://www.doctorofnursingpracticednp.org/capstone-project-guide/ (Links to an external site.) (Links to an external site.) Think about where you work: Are patients being screened properly? …For cholesterol, for breast exams, risk behaviors, psychosocial needs, abuse, hunger, resources. Are follow-up appointments or referrals being scheduled if there is an identified problem? Are the long term needs of your patients being addressed? Are resources or community helps being identified or offered not just for health but to increase quality of life? Are there processes in place to call for spiritual care, pallatative care, hospice, or ethical consults? If so do all employees know about these? Does your clinic have a Reach Out and Read program? Do you have information about resources for medically fragile patients, disabled patients, families dealing with substance abuse, a mentally ill relative, or families dealing with dementia. Stress influences our health; Patients often confide to providers about difficulties. If practitioners are not aware of resources then where will they find help? QI Examples: The obesity initiative started out as an effort to refer patients to a special obesity clinic. However, we soon realized that there was a problem. Somehow we were missing 30% of the patients because they did not have a BMI. We examined the reasons why and discovered that only well check patients were having their height assessed. You must have a weight and height to calculate a pediatric BMI. Thus, we created an educational initiative to make sure all children had a BMI recorded by requiring all patients be assessed for height and weight. After all, you cannot refer a patient if you do not have evidence of obesity! Picture_Obesity Initiative Poster .jpeg Another quality improvement initiative dealt with documentation of care coordinators care plans. These are required and yet they were not being completed. This clinic was trying to attain Patient Centered Medical Home (PCMH) status so this documentation was necessary to provide evidence of proper care for a special population - medically fragile children. Picture_Case management process improvement.jpeg As you can see these were not massive studies but they improved quality of care for patients at the clinic level. Sometimes they improve policies or organizational systems for the providers or staff. Lean Six Sigma (LSS) provides outstanding tools for assessing for improvement. The first thing that is required is to look around where you work for a process that is broken or for an improvement that is needed. Then define the problem or need and how you can measure the change.